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Organization
IRON SPORT LLC
Active
Organization
IRON SPORT LLC
Active
Other names
Lion House Recovery
Organization subpart
No
Provider details
NPI number
Authorized official
WESLEY MICHAEL GOBER (FOUNDER)
(310) 463-1782
Entity
Organization
Contact information
Practice address
65 46TH ST APT 2, WEEHAWKEN, NJ 07086-7168
(310) 463-1782
Mailing address
65 46TH ST APT 2, WEEHAWKEN, NJ 07086-7168
(310) 463-1782
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
05/14/2018
Last updated
01/29/2024
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